AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2013 Issue 4; Ask the Editor

Pharmacomechanical Thrombolysis

A patient presents for pharmacomechanical thrombolysis of left, femoral, popliteal and iliac deep venous thrombosis (DVT). This procedure is currently coded to 39.79 in ICD-9-CM. After referencing the General Equivalence Mappings (GEMS) we noted that the root operation choices for 39.79 are Restriction and Occlusion. We don’t agree with these choices and would like to code the pharmacomechanical thrombolysis of the DVTs to the root operation Extirpation: Taking or cutting out solid matter from a body part. Would you please advise how this procedure should be coded in ICD-10-PCS and is it appropriate to select additional root operations outside of the GEMS? ...

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